As with most topics not clearly addressed within the Qur'an, abortion is
a subject strongly diverse in conclusions. While some may wonder why abortion
should be discussed here at all, a quick reflection on the recent birth of
9 babies at one time (Indonesia all babies died) should bring an answer.
The clear abuse of infertility procedures brings forth several questions
for muslims such as regulations, proper procedures, as well as multifetal
pregnancy reduction. What will be discussed below are the islamic view of
abortion in general, dangers of multifetal pregnancies, and the process of
multifetal pregnancy reduction.

Islamic View

There are two main views of abortion, one view holds
that abortion is prohibited at any point of gestation. Unless it is due to
the threat of the mothers life. This threat is established by the testimony
of three experts regarding abortion as the only means to protect the life
of the mother.

The second main view holds that abortion is permissible
before the soul is given to the fetus. The question of when the soul is given
is broken down to three main views A) 120 days B) 40 days C) when there is
voluntary movement from the fetus. This voluntary movement usually occurs
during the 12th week of gestation, but many women may not notice the movement
until much latter, sometimes 20 weeks.

The allowance of abortion before ensoulment vary greatly between scholars.
Such reasons can include, but are not limited to, rape, threat of life to the
mother, threat of life to an existing child, and serious malformations
of the fetus are legitimate means to terminate the pregnancy.

According to Imam Hanafi if the pregnancy of a woman harms the life of an
already existing child by way of milk production, than the pregnancy can
be terminated. Hanafi happens to be more open in matters of abortion than
the other three madhabhib. This thought can also be taken a step further
such as the threat of one fetus to another, as exhibited in a question posed
to Jamaat e Islami Pakistan.

While I have yet to find a learned muslim who directly takes on the issue
of multifetal pregnancy reduction. I do have hope that one day this, as well
as other issues of infertility, will be fully addressed. All we have to go
on at this point is the indirect rulings and how they are applicable in our
situations.

While pro-life and pro-choice are "hot" debates today, they should not be
a dividing factor within our ummah. We, no matter what madhahib we choose
to follow, or not follow, have a common basis of agreement. And this is the
protection of the mothers life, versus that of the fetus. Islam is not a hard
religion, but one that is justly balanced, to force a woman to die for the
chance birth of her child, out of some "religious" duty is something foreign
to Islamic principles. For the sanctity of life, how strong indeed, is laid
forth in saving the life already established is to supersede the one that
can not exist without the life of the former. If the fetus has the ability
to live on its own than it is given such a chance, if not, the option of abortion is given
to the mother. This is very different then many current rulings in other
religions today.

Multifetal Gestations

There is always a probability of harm to a mother
with any pregnancy. But as the number of fetuses increase, so does the
probability of harm, not only to the mother herself but also to that of fetuses.
Some of which include: miscarriage, congenital
anomalies, hyperemesis gravidarum, anemia, pregnancy induced hypertension,
polyhydramnios, preterm labor and delivery, which would effect the fetuses
with possible abnormalities in lung, heart and kidney development, bleeding
in the brain, low birth weight, intrauterine growth restriction, hemorrhage
(postpartum), cerebral palsy and other neurologic disorders, malpresentation,
dysfunctional labor, and fetal distress.

One has to consider with such a high number of fetuses that a woman's body
is just not made to withstand such a process on a wide scale. While yes,
admittedly there have been several successful births with such high numbers
of 6, or now even 8 fetuses. The question is, what about the non publicized
many who do not have success stories? While we are no longer fascinated with
numbers such as four and five, they do happen relatively, often, considering
it was not long ago such things did not take place on such a level. We do
not hear of the horror stories of women losing all of their babies, or not
only withstanding the loss of one or two, but now having to deal with the
on going damage that the surviving child/ren have to live with day in and
day out. While it may be great if we all had success stories, it would be
wrong of us to glorify having so many children with out understanding the
true nature of this ordeal.

Multifetal Pregnancy Reduction

Multifetal reduction is generally suggested with
four or more fetuses present. The procedure is done between nine and twelve
weeks gestation, and is most successful early in pregnancy. Many times the
reduction is made to two fetuses remaining, but reduction to triplets can
also be taken into consideration, for recent research has suggested no sign
of improvement in perinate morbidity and mortality in triplet
pregnancies.

The process of the reduction is done on an outpatient
basis. A needle is inserted, either through the abdomen or vagina, guided
by an ultrasound, and an injection of potassium chloride is given to the selected
fetus(es). Usually the smallest fetus or the one lowest lying is chosen for
the procedure. There are risks, 75% of pregnancies are subject to premature
labor, the incidence of miscarriage occurs with 4 to 5%. However, there is
data to support longer gestations, higher birth rates, reduced hospital stays,
as well as health benefits for both mother and
children.

Proper procedure

Having gone through infertility treatment, as well as having multiple fetuses
(twins) I do hold some strong opinions on the medical procedures that should
decrease the possibility of multifetal pregnancies. I do question the doctors
procedures when such large numbers of fetuses occur in a single pregnancy.
And than suggest reduction as an option, after the fact, as if this is a
"clinical trial". Infertility treatments have been successful enough for
doctors to know and follow simple suggested guidelines. But between a combination
of couple emotions, doctors inability to look beyond statistics, realizing
that things can actually go the way they don't expect them to, and the bottom
line of "how much does it cost". If the procedure to monitor egg production
is followed, than a doctor should never make the mistake of giving HCG to
a patient who has four, six, and even eight eggs developing. If doctors did
not give patients higher dosages of drugs in order to increase egg production
just because a woman has not conceived, ignoring, or not taking the time
to find out if she is indeed ovulats. And if doctors, as well as patients
did not insist that so many embryos be used for implantation, than the
possibility of such "miracle events" would surely decrease.

As Muslims we have a greater responsibility, we must take precautions to
lesson the likelihood that such things will happen.It is up to the patient
to become educated and make the doctor follow guidelines that you feel secure
with. It is the patients choice of how many embryos are placed in her uterus.
The doctors can not make the mistakes by themselves, we as patients bear
a burden of responsibility also. While many may become overwhelmed between
emotions of wanting a child, the financial hardships of infertility treatments,
as well as the spiritual struggles infertile couples endure, we as muslims
have a strong foundation in which we should seek proper guidance in all matters
that we undertake. We should not let our emotions, wallets, or any other
thing lead us in a matter for this will be our downfall. It is very important
that we do all that is possible to prevent such incidents. This I can not stress
enough, muslims must seek guidance with Allah even though such treatments
are halal. We must remember to put our duties as muslims first, rather than
our desire to have children..

The Choice

I would love to ensure all couples that this situation
will never happen to them while undergoing infertility treatment. Even with
all the precautions we take, this may still happen to any couple facing a
high number of fetuses. However, like all things
that we face it is important to go into a situation fully educated with ones
options. While I would never suggest that one undergo this procedure nor
deter one in their decision to do so, for this is not my place, I do pray
for all muslim couples facing this matter today and in the future (inshallah).

On no soul doth Allah Place a burden greater than it can bear. It gets every
good that it earns, and it suffers every ill that it earns. (Pray:) "Our
Lord! Condemn us not if we forget or fall into error; our Lord! Lay not on
us a burden Like that which Thou didst lay on those before us; Our Lord!
Lay not on us a burden greater than we have strength to bear. Blot out our
sins, and grant us forgiveness. Have mercy on us. Thou art our Protector;
Help us against those who stand against faith." (2:286)

But those who believe and work righteousness,- no burden do We place on any
soul, but that which it can bear,- they will be Companions of the Garden,
therein to dwell (for ever). And We shall remove from their hearts any lurking
sense of injury;- beneath them will be rivers flowing;- and they shall say:
"Praise be to Allah, who hath guided us to this (felicity): never could we
have found guidance, had it not been for the guidance of Allah: indeed it
was the truth, that the messengers of our Lord brought unto us." And they
shall hear the cry: "Behold! the garden before you! Ye have been made its
inheritors, for your deeds (of righteousness)."